Loading...
HomeMy WebLinkAbout10 HOMESTEAD DR Electric # APPLICATION FOR BUILDING PERMIT Plumbing# Date: CO'O'' U IJ HVAC # 10 Homestead Drive Sprinkler ___3232.fl -_ - _---- ___ -_ Estimated Cost $ S FINAL APPROVALS - _ --- - - ' Permit Fee $ Building COMPLETE RED BOXED AREAS Occupancy Fee $ Engineering TYPE OR PRINT ONLY Affidavit Eng. Insp. Fee $ Appr. for CO. SIGN ON REVERSE SIDE / ' 4/� -- ---- -- --- - -- Total Fee $—L�� -- -- OF TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant a i ` �V0 k s Q r L ati -*-E� W on of Work D b AV S Lot No. Applicant's Address S kt,5 l Tel.# o ' `i?Y 144 Town ✓ Zip CT Lic.# 5? 3,33 Owner Architect Owner's Addr [ o r Architect's Address C ! Zip - zip-Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. —Total-New yea Purpose of this permit C i'ki55 fell City Watero Wello Septic Systemo Sewero Ins: HO SP Cert. Area Basement Garage Approved by Dat Use Group,----- roup Construction Type Revised 6102 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS APPLICATION FOR:ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR pg,RMU# Appli atio BUILDING DEPARTMENT AP 1540 SULLIVAN AVENUE 644-251 i.ext. 230 Bldg..Permit# Date 6ng Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$I,000=$15.00 Over$1,000= Street No. Street Lot No. $15.00.per$1,000 . or any fraction thereof Tenant Designation Apt.No. APPLICANTc,, c APPLICANT ADDRESS _ F-/ APPLICANT'S PHONE# p OWNER 0W N 84.'44 OWNER ADDRESS O F OWNER PHONE Q ESTIMATED COST$ "1 � IS THIS A CONTRACT OST? Yes No FEE ENCLOSED,$ - 1� TYPE OF JOB: dSOR•COS New Installation Alteration/Addition/Repair Revised 03/05/10 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BULDING IS THIS APPLICATION ASSOCIATED WITH�A� BUILDING PERMIT APPLICATION? ❑ YES . O ❑ RESIDENTIAL CURRENT USE AND OCCUPANCY IQC7 ❑BUSINESS " ❑.ASSEMBLE' FUTURE USE AND OCCUPANCY ❑ EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME PHONE: LI FACTORY ❑ STORAGE ADDRESS ❑ GARAGE . Cl MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE v SIZE OF MAIN CONDUCTORS. ) NUMBERS OF METERS NUMBERS.OF DISCONNECTS AND RATINGS NUMBERS OF PANELS NUMBERS.OF DISCONNECTS REQUIRED? ❑ YES ❑ NO NUMBERS OF LIGHT CIRcuns NUMBER OF POWER CIRCUITS. NUMBER OF SWITCHES. NUMBER OF OUTLETS NUMBER OF LIGHT FDCTURES NUMBER OF HEAT CIRCUITS. NUMBER`OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK THE UNDERSIGNED HEARBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFOR- MANCE OF SUCH WORK CONTRACTORS LICENSE NO. STATE SIGNATURE OF APPLICANT41 DATE ��J�- Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- **-32328-B 2,750 B10 FINAL 02/16/06 PJP D NEED INFO FROM MANUFAC.RE:ENCLOS URE FOR COLD CLIMATES B10 FINAL 02/16/06 PJP A RECEIVED FAX RE COLD CLIMATE IN STALLATION Q ENCLOSURE DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE 644-2511 EXT.230 i Bldg. 2- # 3o0 623g (Date) (Building Inspector) Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. `J Street Lot No. Over$1,000- $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT T1b&jCbj<+, rr .UL,\Ce- �At �'' APPLICANT ADDRESS Ce Ll u k wf w 'q W J �. iyLko r APPLICANT PHONE# 0 QO V OWN SF OWNER iF- tS OWNER ADDRESS C 00 OWNER PHONE O C J -L(C ! ESTIMATED COST $ 11600 IS THIS A CONTRACT OST? YES V NO FEE ENCLOSED$ 4 Cj© TYPE OF JOB: C454-1 �SOR•C0 /NewInstallation nlQe�s f Alteration/Addition Repair I`t 3 Revised 12/22/11 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION? r`7 YES ❑ NO O BUSINESS CURRENT USE AND OCCUPANCY G� O ASSEMBLY O MERCANTILE O EDUCATIONAL FUTURE USE AND OCCUPANCY O FACTORY ENGINEER'S NAME PHONE q�C } O STORAGE L'GARAGE C3 MIXED USE ADDRESS1_� V�{�,� t t1'J (Other please specify) CITY S_ L j LtiCSO r STATE Off- ZIP TYPE OF INSTALLATION !f hftL SIZE OF MAIN DRAIN NO. OF TOILETS STYLE NO. URINALS STYLE NO. OF BATHTUBS NO. OF SHOWERS NO. OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO. OF CATCH BASINS NO. OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND 15414,s ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW O YES CY NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS 1 f) SEWER OR SEPTIC TANK I /qSIZE OF WATER MAIN 3 /1 SIZE OF WATER PIPING&RISER 3 WATER HEATER: TYPE A& 3dVA MANUFACTURER DESCRIPTION OF WORK w SW144 10 QQ bJ1C00rrx - - THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. TYPE STATE* SIGNATURE OF APPLICANT — DATE 77 " E o pr; LOT AREA 22,843 s.f. ' Existing House 1 fin.fir. 343.69 o gar. 342.27 a N ,0 t ti o 2.0, �0 75 CO w ' water 23.5' 27.0' ro i � $ I w i i A 27.9' o r I I. 27.0' , 1 18.0 20.17 i r — - 50' bldg. line 1 $ n_90"Oo'Od' Z i R=25.00 I' c0 rn T=25.00' c0 t L=39.27' 9 .45' S 210,'10� " W --st. line i storm rrhMilk Irr— son. Map Reference: � ��— -----------------------------e-P• Plot Plan Resubdivision Parcel"A" TIMBER KNOLL property of , TQM BUILDING COMPANY South Windsor, Conn. PHASE III Scale: I"=40' Sht. 5 of 14 Oct. 1975 Rev.thru Feb. 15,1979 Myron Feinstein Associates AS—BUILT PLAN FOR LOT 76 / HEREBY CERr/t Y rH/S MAP rO BE SuerANriALLY CORRECT. T&M BUILDING C 0. C26-- South Windsor, Conn. Robert T. Dayton Conn.L 157 a ' AUG. 13, 1981 SCALE I =40 dpgjI APPR_ OV �D TOWN Or SOUTH NMND!�;G9R ENGINEERING DEPA:TMENT DATE: f ti� lip3 co / / CIO le el / i -3 w t ' i •-1 � 1 II N 335.5 t j 31+11.0 - dam 016 1 zz v1 eOr �zs,� 3�- L*;4•tt' i ,MAP O6F&JWAZE T .;¢��unLt►vr�.c�-.P...drzcCt�_"��� E,xl��lq Ccr1�»v�c -- 332--- i A4Va t . P,2o/%4'-yy Co Pttoro5ty r-�-- - - '7'� GQ.vt P.4N-/ if E oN t ' c.�,i..� : •' _ ���, 5,�1�6�-Sam/� PQaPosD LAYot.JT /493 , )2EV. TAb2u Fes$IAS./97 j r� ..M-�'Qat/ �-fa�15]'dE/hl.�.L.S• Vl t-1 P ram.... , G� . t M Cam-'F`C a �.7vBS't'ArJT lA3.L CO�LQcc-c � t U 0� � � ��- p, P p_ 50,,E H �T�:1ENi T�`��1� �CR��G �V� , ti�� � �. 9��E: � SSG.; } yb 33° CIO 00, / 001 3ZZ w 1 r / / � � 1 / H -' I N 335• 4 1105 U1 1 � � � q�6r �.¢• r �'► 4-1 / (11 Z 8� Al tt r (pp 332� �`� +� 32?•S� 33r; 3� f i MAP JZEFE,f 044C- �RPI.caT 4;=r► c, t7P.G1 t.l F I AA= u4 ~A~ UI5VIJIt C014TO C T1M�!l3r.Q �4r/ct.[. P�¢opi, y' cs QIZoPaSG» 332 - - i' GQA4PAA/�/ rl El.rfia�-rtr� t 3r1{rK c.�► : / - �n�, s.���,-so���F PQoPos�D LAYovT -AA-Y'Qea�/ .9-41A,srAtN ;L..S ScxsrM ; M �4&spmB-e Cam-i1=`< �a1�5 MAP TO -be �v$'=�'t'ANT IA1.L CORFZtAT tZoB�.�r T ��.Y�-o� �..S. S►�� �'I ` STATE OF CONNECTICUT ®MR DEPARTMENT OF MENTAL RETARDATION IYEST REGION M.JODI RELL Peter H. O'Meara GOVERNOR COMMISSIONER 1v4r.Thomas Harvey March 06,2006 Kathryn duPree The Mav Institute CT Communit DEPUTY COMMISSIONER 3 60 Tolland Turnpike, Suite 2D Manchester, CT 06040 RE Homestead Drive R-658 R-658 10 Homestead Drive South Windsor Dear Mr. Harvey Based on a review of documentation provided by your agency,the Department of Mental Retardation has established your facility's"Evacuation Difficulty Score"(E-Score"),under the 1997 NFPA 101,Life Safety Code.This score and related information is detailed below. This"B-Score"is valid only as long as the information listed below is still valid,and only for the clients listed below, provided there are no changes in their physical or mental condition, since the survey date.It is your responsibility to notify this office of any new clients not listed below,or of changes in client conditions or staffing levels that have changed since the date of the survey. Please contact Acting Fire Chief Thomas P.Bowolick at Southbury Training School Fire Department,P.O.Box 872, Southbury, CT 06488-0901. Telephone: 203-586-2638/Fax: 203-586-2722. This documentation, along with a copy of the survey provided by your agency, should be kept in your files to be made available for the fire marshal's use during the annual licensure inspection of your facility. E-Score Evaluation Date:January 13, 2006 DMR Region:NR Evacuation Capability:N/A-<4 E-Score Status:Annual Vertical Distance:0-not yet entered Staff Score:0-not yet entered Provider Survey By: E-Score Evaluator:Baldwin E-Scores are calculated using the following formula: Sum of all individual e-scores times the vertical distance divided by the staff score. Sincerel Thomas Bowo tck,Acting Fire Chief Department Mental Retardation cc:Fire M shal Regional Director File FIRE MARSHAL PLEASE NOTE:DMR must comply with the Healthcare Insurance Portability and Accountability Act of 1996(HIPAA).This law provides for the privacy and security of healthcare information and has regulations which'covered entities'such as DMR must follow. The sharing or disclosure of information is allowed only as required and permitted bylaw,or when an individual has given DMR permission. The privacy rule includes information that can be used to identify individuals,such as but not limited to name,DMR number,locations or addresses. you are not covered by HIPAA but we ask that you help us respect the rights of the consumers we serve and therefore request that you keep the identities agile I r�pgal. Phone:(203)586-2000;TDD: (203)586-2001;Fax:(203)586-2700 An Equal Opportunity Employer July 2, 2002 To Whom It May Concern; On Jul 2, 2002 I did inspect the group home Homestead CLA located at 10 Homestead Y P 2�' P Drive South Windsor, Ct. this facility does meet with the Fire Code requirements for a facility housing three clients. The request has been made to allow the facility to temporally increase the client occupancy to four. I have no problem with this increase. However,this approval will be granted until September 15, 2002 only. After that date the facility would have to be brought up to the required code mandates. William R. Lanning Fire Marshal South Windsor STATE OF CONNECTICUT ®MR DEPARTMENT OF MENTAL RETARDATION CVI \ ..1. S Tiv�.VS>y IVEST REGION M.JODI RELL Peter H.O'Meara GOVERNOR COMMISSIONER Kathryn duPree RE: HOMESTEAD DRIVE, R-658, 10 Homestead Drive, So. Windsor, CT 06074 DEPUTY COMMISSIONER Date: March 6, 2006 To Whom It May Concern: Based on a review of documentation provided by your Agency and subsequent discussions with staff, in accordance with the 1997 NFPA 101 Life Safety Code, we are unable to establish an "Evacuation Difficulty Score(E-Score)"at this time. A basic tenet of establishing E-Scores is that certain criteria detailed in NFPA 101A (1995 Edition) must be met before establishing an E-Score. The criteria that was NOT met by this facility is: The Connecticut Life Safety Code requires that evacuation scores be determined for Board and Care Facilities with four or more residents. To properly evaluate the facility, all four of the residents need to have participated in at least six fire exit drills. At this time not all residents have participated in at least six drills, or there are less than four residents. When you have 4 residents and / or have completed six drills with all residents (maximum 6 months time), please contact Fire Officer Timothy Baldwin at (203) 586-2444, or E Mail at timothy.baldwinCabpo.state.ct.us, to begin the evacuation score process. If I can be of any further assistance, please do not hesitate to contact me. Thomas R Bowolick, Acting'FlXdhief State of Connecticut, Dept of Mental Retardation Southbury Training School Department of Fire and Emergency Medical Services Voice 203-586-2638, Fax 203-586-2722 Thomas.Bowolickfto.state.ct.us cc: Susanna Lennon—DMR Licensing, Fire Marshal, File Forml-etter 2 No E-Score due to need 4 residents w 6 drills each.doc Southbury Training School Phone:(203)586-2000;TDD:(203)586-2001;Fax:(203)586-2700 An Equal Opportunity Employer - STATE OF CONNECTICUT L;MI? DEPARTMENT OFMENTAL RETARDATION T`ANS� WEST REGION M.JODI RELL Peter H.O'Meara GOVERNOR COMMISSIONER To: Fire Marshal William R.Lanning,South Windsor Vol. Fire Dept Kathryn duPree Drawer"R" Sout Windsor,CT 06074 DEPUTY COMMISSIONER Date: Thursday,March 10,2005 Re: 10 Homestead Drive,South Windsor CT -DMR License#R-658 The Office of the State Fire Marshal and the State of Connecticut, Department of Mental Retardation are providing an"Outreach Program"for Residential Board and Care Facilities throughout the State of Connecticut. A site visit was recently conducted at the referenced Private Residential Board and Care Facility in your jursidiction,and a report of issues identified is attached for your information. This site visit was also conducted as part of the Department of Mental Retardation's Program to determine accurate and consistent Evacuation Scores, for use by the local Authority Having Jurisdiction and / or DMR Licensing Inspectors. These site visits are conducted for facilities upon initial licensing by DMR, and are conducted on a random basis to assure accurate and consistent Evacuation Scores throughout the state. The site visit was conducted by a Southbury Training School Fire Officer who has completed the Department of Public Safety Fire Marshal / Inspector Certification course. In addition, the local Authority Having Jurisdiction was also contacted and may have accompanied the STS Fire Officer, as well as possibly,a representative from the State Fire Marshal's Field Services Division. The purpose of this site visit was to meet with the facility staff to assure they understand the evacuation score process and to assure the"building aspects"of the evacuation score are accurate(i.e.: bedrooms on level of exit discharge, etc...). In completing the survey, our evaluator also conducted a fire safety inspection and may have conducted a Fire Evacuation Drill. A summary of Issues noted is attached for your information. Facility staff and administrators have been encouraged to correct any issues that are easily corrected (i.e.: use of extension cords) but are also encouraged to consult with their local fire marshal before directly addressing any of the other issues in the attached report. They have also been reminded that their local fire marshal is the authority havine jurisdiction, and should be consulted on all issues relative to fire code compliance. If you have an questions or concerns lease feel free to contact us. Y Y9 P Sincerely, Y Nicholas E. Gabriele,Fire Chief Ralph C. Miller,Supervisor State of CT Department of Mental Retardation Office of State Fire Marshal Southbury Training School Field Services Section Department of Fire and EMS Services Bureau of Engineering Phone:(203)586-2638 Phone: (860)685-8350 Email: Nicholas.Gabrielena po.state.ct.us Email : Ralph.mille6)po.state.ct.us Cc: Agency Director Susanna Lennon—DMR Licensing file Southbury Training School Phone: (203)586-2000;TDD:(203)586-2001; Fax: (203)586-2700 An Equal Opportunity Employer State of Connecticut Department of Mental Retardation Southbury Training School Department of Fire and EMS Services DMR Evacuation Score Determination Site Visit Issues Noted Summary Facility Name: Homestead Drive R-658 DMR License# R-658 Address: 10 Homestead Drive, South DMR Region: North Windsor Agency: The May Institute Date of Site Visit: 2-17-05 E-Score: Prompt Site Visit Inspector: Baldwin LOCATION CT STATE FIRE SAFETY CODE ISSUE NOTED COMMENTS , NFPA 101 OTHER CODES NO EVACUATION SCORE ISSUED HOME FOUND AND VERIFIED AS HAVING LESS THAN 4 OCCUPANTS NO SITE INPSECTION COMPLETED. Evacuation Score Verification Results N/A METHOD: AT APPROXIMATELY N/A HRS A FIRE EVACUATION DRILL WAS CONDUCTED AND OCCUPANTS WERE EVACUATED IN APPROXIMATELY MINUTE(S).IN ADDITION,EVACUATION SCORE INFORMATION PROVIDED BY THE FACILITY IN MAILED-IN SURVEY WAS VERIFIED.THIS INFORMATION INCLUDES STAFFING LEVELS AND TRAINING,OCCUPANTS INDIVIDUAL EVACUATION CAPABILITY AND BUILDING FEATURES. M \ ©���. . ' -•STATE OF CONNECTICUT DEPARTMENT OF MENTAL RETARDATION WEST REGION NI.JODI RELL Peter H.O'Meara GOVERNOR COMMISSIONER Mr.Thomas Harvey Kathryn duPree The May Institute DEPUTY COMMISSIONER 360 Tolland Turnpike Suite 2D Manchester, CT 06040 RE: HOMESTEAD DRIVE, R-658, 10 HOMESTEAD DRIVE, WINDSOR Date: MARCH 17, 2005 To Whom It May Concern: Based on a review of documentation provided by your Agency and subsequent discussions with staff, in accordance with the 1997 NFPA 101 Life Safety Code, we are unable to establish an "Evacuation Difficulty Score(E-Score)"at this time. A basic tenet of establishing E-Scores is that certain criteria detailed in NFPA 101A(1995 Edition) must be met before establishing an E-Score. The criteria that was NOT met by this facility is: The Connecticut Life Safety Code requires that evacuation scores be determined for Board and Care Facilities with four or more residents. To properly evaluate the facility, all four of the residents need to have participated in at least six fire exit drills. At this time not all residents have participated in at least six drills, or there are less than four residents. When you have 4 residents and / or have completed six drills with all residents (maximum 6 months time), please contact Fire Officer Timothy Baldwin at (203) 586-2444, or E Mail at timothy.baldwin0po.state.ct.us, to begin the evacuation score process. If I can be of any further assistance, please do not hesitate to contact me. Z- "a&, N c olas E. G riele, Fire Chief Soto of Connecticut, Dept of Mental Retardation Southbury Training School Department of Fire and Emergency Medical Services Voice 203-586-2638, Fax 203-586-2722 Nicholas GabriekQmstate.ct.us cc: Susanna Lennon—DMR Licensing, Fire rshal, File FormLetter 2 No E-Score due to need 4 residents w 6 drills each.doc Southbury Training School Phone:(203)586-2000;TDD:(203)586-2001;Fax:(203)586-2700 An Equal Opportunity Employer 1500502 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ELECTRICAL PERMIT DATE: 12/17/2015 GIS ID:44700010 FEE: 15.00 MUNIS APPLICATION# 201501834 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: MAINVILLE ELECTRIC v ADDRESS: 10 HOMESTEAD DRIVE ADDRESS: 88 BRAMBLEBRAE OWNER: JOURNEY FOUND INC SOUTH WINDSOR,CT 06074 60 HILLIARD ST MANCHESTER,CT 06040 DESCRIPTION OF WORK: WIRE PORTABLE GENERATOR HOOK-UP. 30 AMP TO PANEL INTERLOCK KIT. SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 12/17/2015 2:17 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE